首都医科大学学报 ›› 2022, Vol. 43 ›› Issue (2): 244-248.doi: 10.3969/j.issn.1006-7795.2022.02.014

• 精神疾病神经调控和康复技术研究 • 上一篇    下一篇

经颅交流电刺激联合抗抑郁药对抑郁发作的疗效及安全性

罗炯1,2, 孙丛丛1,2, 潘伟刚1,2, 王丹1,2, 史晓宁1,2, 王茜1,2, 金文青1,2, 梁立荣3, 杨春林1,2, 马辛1,2, 任艳萍1,2*   

  1. 1.首都医科大学附属北京安定医院精神科 精神疾病诊断与治疗北京市重点实验室&国家精神心理疾病临床医学研究中心,北京 100088;
    2.首都医科大学人脑保护高精尖创新中心,北京 100069;
    3.首都医科大学附属北京朝阳医院 北京市呼吸疾病研究所临床流行病学研究室,北京 100020
  • 收稿日期:2021-11-10 出版日期:2022-04-21 发布日期:2022-04-14
  • 基金资助:
    北京市科学技术委员会科技重大专项(D171100007017001)。

Efficacy and safety of transcranial alternating-current stimulation combined with antidepressants in the treatment of depressive episode

Luo Jiong1,2, Sun Congcong1,2, Pan Weigang1,2, Wang Dan1,2, Shi Xiaoning1,2, Wang Qian1,2, Jin Wenqing1,2, Liang Lirong3, Yang Chunlin1,2, Ma Xin1,2, Ren Yanping1,2*   

  1. 1. Department of Psychiatry, Beijing Anding Hospital, Capital Medical University, Beijing Key Laboratory of Mental Disorders & The National Clinical Research Center for Mental Disorders, Beijing 100088, China;
    2. Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100069,China;
    3. Department of Clinical Epidemiology, Beijing Institute of Respiratory Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
  • Received:2021-11-10 Online:2022-04-21 Published:2022-04-14
  • Contact: *E-mail:renyanping@ccmu.edu.cn
  • Supported by:
    Beijing Municipal Science & Technology Commission (D171100007017001).

摘要: 目的 探讨经颅交流电刺激(transcranial alternating-current stimulation, tACS) 联合抗抑郁药对抑郁发作的治疗效果及安全性。方法 选择抑郁发作患者62例,分为治疗组和对照组,均服用抗抑郁药物,治疗组加用tACS真刺激治疗,对照组加用tACS伪刺激治疗。治疗次数两组均为20次。治疗部位为前额部、双侧乳突部,频率为77.5 Hz,强度为15 mA。采用汉密尔顿抑郁量表-17项(Hamilton Depression Scale-17 Item, HAMD-17),汉密尔顿焦虑量表(Hamilton Anxiety Scale, HAMA)评估患者治疗前后的临床症状,并评估安全性。评估时间点为基线,治疗结束时(4周末),随访时(8周末)。结果 采用重复测量方差分析对治疗组和对照组在基线、治疗4周末、随访8周末时HAMD-17和HAMA的评分进行比较,显示两组HAMD-17总分均随治疗及随访时间的延长逐渐降低(P时间<0.05),治疗组降低幅度大于对照组(P组间<0.05),且随观察时间的延长治疗的效应增大(P交互<0.05)。两组HAMA总分均随治疗及随访时间的延长逐渐降低(P时间<0.05),但两组间差异无统计学意义(P组间>0.05)。治疗组和对照组第4周末HAMD-17的减分率分别为74.29%±8.40% vs 32.54%±13.30%;第8周末HAMD-17的减分率分别为81.00%±10.68% vs 40.27%±12.92%,差异均有统计学意义(P<0.001)。两组均无严重不良事件发生。结论 经颅交流电刺激联合抗抑郁药物治疗抑郁发作能够增强治疗效果,且安全性高,可作为抑郁发作联合治疗的新选择。

关键词: 经颅交流电刺激, 抑郁发作, 疗效, 安全性

Abstract: Objective To investigate the efficacy and safety of transcranial alternating current stimulation (tACS) combined with antidepressants in the treatment of depression. Methods Sixty-two patients with depressive episode were randomly divided into treatment group and control group. Both groups took antidepressants. The patients in the treatment group received real tACS while the patients in the control group were treated with sham tACS. The treatment session was 20 times in both groups. The treatment site was prefrontal and bilateral mastoid, with a frequency of 77.5 Hz and intensity of 15 mA. Hamilton Depression Scale-17 Item (HAMD-17) and Hamilton Anxiety Scale (HAMA) were used to evaluate the clinical symptoms at baseline, the end of treatment (4 weeks), and follow-up (8 weeks). Results The scores of HAMD-17 and HAMA in the treatment and control groups at baseline, 4 weeks of treatment, and 8 weeks of follow-up were compared with repeated measurement analysis of variance. The total score of HAMD-17 in the two groups decreased gradually with the extension of treatment and follow-up time (P time<0.05). The decrease in the treatment group was greater than that in the control group (P group<0.05), and the effect of treatment increased with the extension of observation time (Pinteraction <0.05). The total score of HAMA in both groups decreased gradually with the extension of treatment and follow-up time (P time<0.05). However, there was no significant difference between the two groups (P group>0.05). The score reduction rates of HAMD-17 in the treatment and control groups at the end of the fourth week were74.29%±8.40% vs 32.54%±13.30%, respectively. At the end of the 8th week, the score reduction rates of HAMD-17 were 81.00%±10.68% vs 40.27%±12.92%, respectively. The difference was statistically significant (P<0.001). Conclusion tACS combined with antidepressants is effective and safe in the treatment of depressive episodes. It can be used as a new choice for the combined treatment of depressive episodes.

Key words: transcranial alternating-current stimulation (tACS), depressive episode, efficacy, safety

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